Researchers and clinicians have vigorously researched evidence-based medicine (EBM) practices and have attempted to embed these guidelines into care, yet few have succeeded in the integrating EBM at the point of care. Challenges to integration include the disruption to clinical workflow, complex guidelines that are tedious to memorize, and over triggering of clinical reminders in electronic health records (EHR). Dr. McGinn is a pioneer and a leader and during his AHRQ funded research study, he created an innovative integrated clinical prediction rules (iCPRs) into the EHR, which led to high rates of provider utilization and significant declines in inappropriate antibiotic and diagnostic tst ordering. The large success was a result of thorough pilot and usability testing to determine the best method for incorporating the tool into clinical workflow. Leveraging on Dr. McGinn's expertise in integrating CPR into care, this grant will allow him to develop a team of experts in EBM, informatics, usability testing and integration of CPRs and provide additional resources in establishing an innovative usability lab. In addition to the usability team, we will build an executive advisory board, consisting of international and national experts in EBM and NSLlJ's EBM department. The EAB will attend monthly conference calls to provide feedback on the usability lab's work and insight on their work on dissemination and integration of EBM. We intend to target our services to NSLlJ's hospitals who serve minority communities who are underinsured, specifically Southside, Forest Hills and LU hospitals. The team's focus will be to incorporate the usability science to North Shore-LIJ's (NSLIJ) current efforts in EBM and work with community practices in selecting, tailoring and integrating CPRs at the point of care with the aims of 1) Creating an iCPR integration team who will work with community practices and hospitals to implement validated CPRs at point of care, 2) Increasing use of EBM point of care tools among community practices and hospital physicians, and 3) Creating a sustainable model for disseminating EBM to clinical practices by leveraging on the current efforts of NSLlJ's EBM department and community health organizations.